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1154574796
MILDRED V DEBARGE
LAKE CHARLES, LA
NPI
1154574796
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA 350)
Enumeration Date
2008-10-28
Last Update Date
2008-10-28
Business Address
Ms. MILDRED V DEBARGE LAC
1709 W PRIEN LAKE RD
LAKE CHARLES, LA 70601-8360
Phone number: 337-475-2557
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Mailing Address
Ms. MILDRED V DEBARGE LAC
1709 W PRIEN LAKE RD
LAKE CHARLES, LA 70601-8360
Phone number: 337-475-2557
Copy
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